Relationship between the pharyngeal airway space and craniofacial morphology, taking into account head posture

Muto, Toshitaka; Yamazaki, A.; Takeda, Shigehiro; Kawakami, Joji; Tsuji, Yoshiyuki; Shibata, Toshiyuki; Mizoguchi, Itaru

doi:10.1016/j.ijom.2005.04.022

Cited by 91 publications

(83 citation statements)

References 23 publications

(32 reference statements)

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“…The inclusion of the three hyoid measures in our study was relevant to further describe the changes that occur with the task of voice production in professional opera singing. The findings were consistent with the results of previous studies [5,14]. However in our study the relationships between craniocervical posture and the hyoid bone position were not as strong as those found between cranio-cervical posture and PAS (Table 4).…”

Section: Discussionsupporting

confidence: 93%

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The demands of professional opera singing on cranio-cervical posture

Johnson

Skinner

2009

Eur Spine J

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Difficulty with singing is a rare but important complication following cervical spine surgery but there is little objective information regarding the cervical and head postural changes taking place during singing. The aim of this study was to identify postural changes in the cranio-cervical region associated with the demands of voice production in professional opera singing. The two Roentgen-cephalograms, one of which are taken whilst performing a specified singing task were taken from 18 professional opera students, 12 females (mean age 20.86 ± 3.07 years) and six males (18.66 ± 1.36 years). A paired t test compared mean cranio-cervical postural and pharyngeal/hyoid variables between the two registrations (P = 0.05). The association between the craniocervical postural variables and the pharyngeal/hyoid region in each registration position was examined using Spearman's rank correlation coefficient. In singing, the position of the atlas with respect to the true vertical (P \ 0.001), the axis (P \ 0.001) and the C4 vertebra both with respect to the horizontal (P \ 0.001), and the axis with respect to the cranium (P \ 0.001), were all significantly different to those at rest. Of the cranio-cervical postural variables in the singing registration, the angles measuring positional change of the atlas and C4 relative to the true horizontal were shown be significantly related to an increased pharyngeal airway space at the C3 level (P \ 0.01). An appreciation of the requirement for the cervical spine to undergo postural change during professional opera singing has relevance to the potential impact on voice quality in professional opera singers should they undergo cervical spine surgery.

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Section: Discussionsupporting

confidence: 93%

“…It has been demonstrated that post-operative edema subsequent to anterior cervical discectomy and fusion [1] leads to an average change of 10 mm in airway space at the C4 level [14]. The results of our study demonstrated that an average change in pharyngeal space at the C3 level during singing was 5.97 (±5.99) mm (Table 3).…”

Section: Discussionsupporting

confidence: 55%

The demands of professional opera singing on cranio-cervical posture

Johnson

Skinner

2009

Eur Spine J

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“…Again, a positive correlation between the hyoid position and the oropharyngeal area in the RH-ND group was found in this study, declaring a more forward hyoid positioning after protraction. Accordingly, Muto et al 28 found correlations between the pharyngeal airway and the hyoid position, jaw sizes, maxillary and mandibular prognathism, and mandibular inclination. The hyoid position represents tongue posture and function, and hyoid structures are guided to an anterio-inferior position to avoid compromising the vital airway passage as a compensatory action.…”

Section: Discussionmentioning

confidence: 99%

Effects of reverse headgear on pharyngeal airway in patients with different vertical craniofacial features

et al. 2015

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The aim of this study was to investigate the effects of reverse headgear (RH) on pharyngeal airway morphology in two groups of Class III patients with different vertical craniofacial features in comparison with an untreated Class III group. Seventeen subjects (9 males, 8 females; mean age 11.3 ± 0.98 years) with optimum vertical growth and 17 subjects (10 males, 7 females, mean age 11.5 ± 1.1 years) with a vertical growth pattern treated with a removable intra-oral appliance and a Delaire type facemask were included. An untreated Class III control group of 11 subjects (8 males, 3 females, mean age 9.1 ± 1.1 years) was included to compare the treated groups. The paired t-test for intragroup and one-way ANOVA for intergroup comparisons were performed. The relationships between changes in the craniofacial morphology and airway were assessed by Spearman correlation analysis. The airway dimensions at the adenoid side and soft palate were increased in the treatment groups compared to the control group (p < 0.05). The nasopharyngeal area demonstrated a significant difference in normodivergent and control subjects (p < 0.05). No significant difference was found in the airway morphology due to different vertical features. The effect of RH treatment on the sagittal airway dimensions revealed no significant difference between different vertical craniofacial features in the short term.

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“…This observed difference when compared with 2D linear measurement studies is likely the result of our outcomes being recorded as volumes. However, a high variability for OP airway volume was observed for the evaluated patients in both groups, which was in concordance with the findings of Peters-Schuster et al 26 It should be noted that airway size and shape is extremely variable depending on the head posture and the breathing stage, 23,27 and there are no norms or studies at this point to compare with our results.…”

Section: Discussionmentioning

confidence: 99%

Effects of extraction versus non-extraction treatment on oropharyngeal airway volume

Valiathan

Hans

et al. 2010

The Angle Orthodontist

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Objective: To compare the effects of extraction vs nonextraction orthodontic treatments on oropharyngeal airway volume. Materials and Methods: An existing patient database was screened for pretreatment (T0) and posttreatment (T1) cone beam computed tomography (CBCT) scans and complete medical histories. Twenty patients treated with removal of four premolars (ExtG) and 20 controls (NExtG), were matched for age, gender, ethnicity, height, weight, body mass index, and oropharyngeal (OP) volumes, among other variables. Constructed lateral cephalograms (three skeletal and four dental variables) and OP volumes were measured at T0 and T1 using Dolphin Imaging 11.0. Independent sample t-tests were used to compare the groups at T0 and the outcome variables at T1. Paired sample t-tests were used to compare the mean changes from T0 to T1. Statistical significance was set at P # .05. Results: Changes from T0 to T1 were found to be significant in both groups for CoA, CoGn, U1-FH, and IMPA. In the ExtG alone, U1-Na Perp and L1-Na Perp were also significantly different from T0 to T1. Despite the observed differences, no significant differences were found at the end of treatment between the mean OP volumes for either group (12,675.6 6 4483.6 for ExtG; 12,002.7 6 2857.0 for NExtG, P . .05). Similarly, the mean changes in OP volume (1082.6 mm 3 and 1701.1 mm 3 for ExtG and NExtG, respectively) and increase in mean minimal constricted axial areas (17.4 mm 2 and 1.9 mm 2 for ExtG and NExtG, respectively, P . .05) from T0 to T1 were not significant for the two groups. Conclusion: Extraction of four premolars with retraction of incisors does not affect OP airway volume.

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Relationship between the pharyngeal airway space and craniofacial morphology, taking into account head posture

Cited by 91 publications

References 23 publications

The demands of professional opera singing on cranio-cervical posture

The demands of professional opera singing on cranio-cervical posture

Effects of reverse headgear on pharyngeal airway in patients with different vertical craniofacial features

Effects of extraction versus non-extraction treatment on oropharyngeal airway volume

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